Insurance Claims Coordinator is responsible for coordinating and supporting initiatives relative to the evaluation, processing, and handling of insurance claims for an organization. Acts as a liaison between the organization, its insurance provider and agents, claimants, and policy holders regarding the status and eligibility for coverage for all relevant claims. Being an Insurance Claims Coordinator reviews claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries, and makes recommendations for resolution. Typically requires an associate degree or its equivalent. Additionally, Insurance Claims Coordinator typically reports to a manager. The Insurance Claims Coordinator gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision. To be an Insurance Claims Coordinator typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
The County Commissioners Association of Pennsylvania (CCAP) is the voice of Pennsylvania counties. CCAP provides county leaders with information and guidance related to legislation, education, media, insurance, technology and many other issues that help create and maintain crucial services for residents throughout the state.
CCAP supports county leadership that is responsive to the needs and circumstances of citizens. CCAP stands firmly against state and federal actions that limit fiscal, administrative or programmatic authority over those developed locally.
CCAP Insurance Programs Mission
It is the mission of the CCAP Insurance Programs office to assist counties and county related entities to protect their employees, clients, their property, and financial assets, and the general public which use their facilities.
To accomplish this, CCAP Insurance Programs staff will strive to provide:
CCAP is looking to recruit a Claims Coordinator to support our Claims Team within our Insurance Department.
Claims Coordinator
Overview:
The Claims Coordinator is employed by CCAP to oversee daily the receipt and distribution of property and liability claims, administer reporting as notated in Medicare Section 111, handle administrative claims as well as COMCARE PRO claims, manage and create claims reports for the Insurance Department and regular occurring and special claims projects. The Claims Coordinator is part of the CCAP Insurance Programs Department, performs most work with normal supervision and oversight, and reports to the Claims Director for general direction and work evaluation.
This position is eligible for telework pursuant to CCAP’s telework policy.
Responsibilities & Essential Functions
· Monitoring, setting up and assigning new PCoRP claims.
· Administer CCAP’s Medicare Section 111 Reporting guidelines.
· Review reports and scrub monthly and quarterly data to ensure accuracy of claim data.
· Manage pending claims files, including administrative claims and COMCARE PRO claims.
· Manage, create and modify claim reports for claims teams as well as the Insurance Staff.
· Update the CCAP Claims Manual as needed, including an annual review of the entire Manual.
· Prepare and execute claims report for the COMCARE PRO SAC/membership four times a year.
· Assist the Deputy Director with COMCARE PRO Policy and Claims Handling Standards questions and provision of policy language (completed yearly).
· Maintain and manage all Word merge letters housed in the claim software system. Create new letters, update existing letters as needed and delete letters no longer required.
· Run/review/audit quarterly reports and manage action items that come of the reports. Reports including, but are not limited to Excess Claims, Cyber, Roll Up, Defense Only, Small Reserves, Deductibles, Primary Claimant, etc.
· Serve as backup for RiskMaster Support (DXC).
· Monitors and provides support for sFTP (moveIT).
· Collaborate with the CCAP Finance Department to reconcile claims payments. Manage the administrative work related to Defense Counsel Surveys, including sending out the survey, following up, and compiling results.
· Manage the administrative work related to Coverage Committee meetings, including scheduling the meeting, creating the agenda and collecting the denial letters as well as supporting documentation for review.
· Manage document retention for the Claims Unit, including keeping the first floor claims file room organized and in order, purging claim files for PCoRP, PComp, PELICAN and COMCARE PRO when appropriate.
· Copying, collating, and preparing mailings to CCAP members.
· Serves as the point person on all Member Claims Reviews (both in person and virtual). This includes gathering all reports from staff, collating the reports, pulling program documents and marketing material before returning a final product back to the handling claims rep.
· Filing, correspondence and other administrative duties.
· Serves as the primary person on conducting entity checks (i.e. TIN check) for payees. Serves as a backup on managing the entity database housed in the claim software system.
· Manage special claims projects as assigned.
· Prepare special board reports and presentations, as necessary.
· Performing other assignments and routine business of the association.
Qualifications & Requirements
Required Skills and Knowledge:
Education:
· A Bachelor’s Degree, preferably in business administration, public administration, an insurance or risk management field.
· A proven history of professional growth and a commitment to acquiring and maintaining the knowledge required to perform in the position.
An equivalent combination of experience and education will be considered satisfactory for the position.
Working Conditions and Physical Requirements:
· The standard office hours of the Association are 8:30am - 4:30pm.
· Periodic travel will be required, primarily within the state of Pennsylvania, to CCAP members, insurance producers, board and committee meetings, and workshops and other partners as needed.
· Periodic travel outside of Pennsylvania for renewal meetings and training conferences.
· The position may require standing or sitting for extended periods of time and the ability to operate computer equipment essential to the completion of the position’s responsibilities.
· Ability to occasionally lift up to 50 pounds of materials is required.
FLSA: For purposes of the Fair Labor Standards Act, this position is a full-time exempt position.
Job Type: Full-time
Pay: $40,000.00 - $50,000.00 per year
Benefits:
Work setting:
Work Location: Hybrid remote in Harrisburg, PA 17110
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